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"When a car overtook me I slowed down … (then) at a certain moment everything shook. The car in front of me disappeared and seemed to be swallowed up by the clouds. I looked up and saw the bridge pylon fall," he said.

"Instinctively, finding myself in front of the void, I put the van into reverse, to escape this hell."

The driver left his green lorry precariously close to the edge of the collapsed road, telling Italian media how he had escaped the "hell" of the bridge collapse.

"It was raining very hard and it wasn't possible to go very fast," he told the Corriere della Sera newspaper.

The truck driver's incredible tale of survival comes as authorities begin to name the victims.

Authorities have confirmed at least 39 people have died and 15 were injured after the bridge collapsed.

Italy's government has blamed the firm that operated the collapsed Genoa bridge for the disaster as it announced a state of emergency in the region.

Search operations are continuing and rescuers have spent the past few nights digging through mountains of crushed concrete.

A vast span of the Morandi Bridge caved in during a heavy rainstorm in the northern port city on Tuesday, sending about 35 cars and several trucks plunging 45m onto railway tracks below.

The tragedy has focused anger on the structural problems that have dogged the decades-old bridge and the private sector firm Autostrade per l'Italia, which is currently in charge of operating and maintaining swathes of the country's motorways.

Italian deputy prime minister Luigi Di Maio said the tragedy "could have been avoided". "Autostrade should have done maintenance and didn't do it," he alleged.

Prime Minister Giuseppe Conte also confirmed that his government would push to revoke the company's contract for the A10 motorway, which includes the bridge, while Transport Minister Danilo Toninelli said the company should be fined up to €150 million ($A235 million).

The firm, which said the bridge had been undergoing maintenance work, released a statement refuting accusations of underfunding of motorway infrastructure.

"In the last five years (2012-2017) the company's investment in the security, maintenance and strengthening of the network has been over €1 billion [$A1.5 billion] a year," it said.